The numbers of cases and cause-specific deaths refer to data recorded in National Notifiable Disease Reporting System in China, which includes both clinically-diagnosed cases and laboratory-confirmed cases. Only reported cases of the 31 provincial-level administrative divisions in Chinese mainland are included in the table, whereas data of Hong Kong Special Administrative Region, Macau Special Administrative Region, and Taiwan, China are not included. Monthly statistics are calculated without annual verification which is usually conducted in February of the next year for de-duplication and verification of reported cases in annual statistics. Therefore, 12-month cases could not be added together directly to calculate the cumulative cases because the individual information might be verified via National Notifiable Disease Reporting System according to information verification or field investigations by local CDCs.

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Seasonal Patterns: Based on the monthly data, a consistent pattern emerges indicating higher cases and deaths during the winter months (December to February), and lower cases and deaths during the summer months (June to August). This suggests a seasonal pattern in disease transmission, with a higher incidence during colder months and a lower incidence during warmer months.
Peak and Trough Periods: The peak period for cases in mainland China occurred in January 2023, with a recorded value of 4,171,295 cases. The trough period for cases was in August 2010, with a recorded value of 591,982 cases. Similarly, for deaths, the peak period occurred in December 2019, with a recorded value of 2,767 deaths, and the trough period occurred in April 2012, with a recorded value of 1,235 deaths.
Overall Trends: Upon examining the overall trend, there has been an increasing incidence of cases and deaths from 2010 to June 2023. While there have been fluctuations during certain years, the general trend has been upward. However, it is worth noting a sudden decrease in reported cases and deaths in January and February 2013. This significant decline could be attributed to issues related to data collection or reporting.
Discussion: The seasonal patterns observed in the data provide evidence of a seasonal trend in disease transmission in mainland China, with higher cases and deaths occurring during the winter months. This can potentially be attributed to various factors such as increased indoor gatherings, reduced ventilation, and closer contact during colder months. The consistent pattern of higher incidence in winter and lower incidence in summer underscores the importance of seasonal variations in public health measures and interventions.
The overall increasing trend in cases and deaths highlights the ongoing spread and impact of the disease over time. It is imperative for public health authorities to closely monitor and respond to these trends in order to prevent further transmission and mitigate the impact on public health. Additionally, the sudden decrease in reported cases and deaths in January and February 2013 raises concerns about the accuracy and completeness of the data during that period.
It is important to acknowledge that this analysis solely relies on the provided data and does not consider other potential factors that may influence the observed patterns and trends. As a result, further analysis and investigation are necessary to fully comprehend the underlying factors driving the observed patterns and trends in cases and deaths in mainland China.